Dermatopolimiosite: avaliação de 63 pacientes

Marchiori, Paulo E.; Hirata, Maria Teresa A.; Scaff, Milberto; Oliveira, Ricardo Manoel de; Cossermelli, Wilson; Levy, José Antonio; Assis, José Lamartine de

doi:10.1590/S0004-282X1987000200006

Resumos

Sessenta e três pacientes com dermatopolimiosite são avaliados mediante exames clínico, laboratorial, eletroneuromiográfico e anatomopatológico (tecido muscular corado pela hematoxilina-eosina) e pela resposta terapêutica. Trinta e nove são do sexo feminino e 24 do sexo masculino. Média etária de 36,83 ± 15,64 anos. Duração média da doença de 3,74 ± 4,26 anos. São verificadas influências do uso de corticosteróides e ou drogas citolíticas no comportamento enzimático e resposta clínica dos pacientes. Análises são realizadas com intuito de se determinar fatores que pudessem definir os grupos quanto a resposta clínica à terapêutica empregada.

Sixty-three patients with dermatopolymyositis were evaluated from the clinical, laboratory and therapeutical aspects during a period of 15 years: 39 are womem and 24 men. The mean age was 36.8 ± 15.6 years. No correlation was observed between clinical and isolated therapeutics employed; when corticosteroids and cytolytic drugs were used simultaneously, the clinical response was satisfactory. No special fact was seen that can predict the therapeutical response.

Dermatopolimiosite: avaliação de 63 pacientes

Dermatopolymyositis: evaluation of 63 patients

Paulo E. Marchiori^I; Maria Teresa A. Hirata^II; Milberto Scaff^III; Ricardo Manoel de Oliveira^IV; Wilson Cossermelli^V; José Antonio Levy^III; José Lamartine de Assis^III

^IMédico Assistente da Divisão de Clínica Neurológica (CN) do Hospital das Clínicas (HC) da FMUSP - Trabalho realizado nas Disciplinas de Neurologia Clínica e de Reumatologia da Faculdade de Medicina da Universidade de São Paulo (FMUSP)

^IIMédica Preceptora da CNHCFMUSP - Trabalho realizado nas Disciplinas de Neurologia Clínica e de Reumatologia da Faculdade de Medicina da Universidade de São Paulo (FMUSP)

^IIIProfessor Adjunto de Neurologia - Trabalho realizado nas Disciplinas de Neurologia Clínica e de Reumatologia da Faculdade de Medicina da Universidade de São Paulo (FMUSP)

^IVAuxiliar de Ensino de Reumatologia - Trabalho realizado nas Disciplinas de Neurologia Clínica e de Reumatologia da Faculdade de Medicina da Universidade de São Paulo (FMUSP)

^VProfessor Titular de Clínica Médica (Reumatologia) - Trabalho realizado nas Disciplinas de Neurologia Clínica e de Reumatologia da Faculdade de Medicina da Universidade de São Paulo (FMUSP)

RESUMO

Sessenta e três pacientes com dermatopolimiosite são avaliados mediante exames clínico, laboratorial, eletroneuromiográfico e anatomopatológico (tecido muscular corado pela hematoxilina-eosina) e pela resposta terapêutica. Trinta e nove são do sexo feminino e 24 do sexo masculino. Média etária de 36,83 ± 15,64 anos. Duração média da doença de 3,74 ± 4,26 anos. São verificadas influências do uso de corticosteróides e ou drogas citolíticas no comportamento enzimático e resposta clínica dos pacientes. Análises são realizadas com intuito de se determinar fatores que pudessem definir os grupos quanto a resposta clínica à terapêutica empregada.

SUMMARY

Sixty-three patients with dermatopolymyositis were evaluated from the clinical, laboratory and therapeutical aspects during a period of 15 years: 39 are womem and 24 men. The mean age was 36.8 ± 15.6 years. No correlation was observed between clinical and isolated therapeutics employed; when corticosteroids and cytolytic drugs were used simultaneously, the clinical response was satisfactory. No special fact was seen that can predict the therapeutical response.

Texto completo disponível apenas em PDF.

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Clinica Ncurológica, FMUSP - Caixa Postal 3461 - 01000 - São Paulo, SP - Brasil.

1. ARAHATA, K. & ENGEL, A.G. - Monoclonal antibody analysis of mononuclear cells in myopathies: III. Immunoelectronic microscopy aspects of cell-mediated muscle fiber injury. Ann. Neurol. 19:112, 1986.
2. BANKER, B.G. & VICTOR, M. - Dermatomyositis (systemic angiopathy) Of childhood. Medicine (Baltimore) 45:261, 1966.
3. BARNES, B.E. - Dermatomyos.t.s and malignancy: a review of the literature. Ann. Med. 84:68, 1976.
4. BARWICK, D.D. & WALTON, J.N. - Polymyositis. Amer. J. Med. 35:646, 1963.
5. BEHAN, W.M.H. ; BARKAS, T. & BEHAN, P.D. - Detection of immune complexes in polymyositis. Acta neurol. scand. 65:320, 1982.
6. BENBASSAT, J.; GEFEL, D. ; LARHOLT, K. ; SUKENIK, S. ; MURGENSTERN, V. & ZLOTNICK, A. - Prognostic factors in polymyositis-dermatomyositis : a computer-assisted analysis of ninety-two cases. Arthr. and Rheum. 28:249, 1985.
7. BENNINGTON, J.L. & DAU, P.C. - Patients with polymyositis and dermatomyositis who undergo plasmapheresis therapy. Arch. Neurol. 38:553, 1981.
8. BOHAN, A. & PETERS, J.B. - Polymyositis and dermatomyositis. N. Engl. J. Med. 292:403, 1975.
9. BOHAN, A.; PETERS, J.B. ; BOWMAN, R.L. & PEARSON, CM. - A computer-assisted analysis of 153 patients with polymyositis and dermatomyositis. Medicine (Baltimore); 56:255, 1977.
10. BROWN, M. ; SWIFT, T.R. & SPIES, S.M. - Radioisotope scanning in inflammatory muscle disease. Neurology 26:517, 1976.
11. BUNCH, T.W. - Prednisone and azathioprine for polymyositis. Arthr. and Rheum. 24:45, 1981.
12. CABANEL, G. ; VOOG, R. ; MARCHAL, A. & COUDERC, P. - Polymyosite aique oedémateuse. Sem. Hôp. Paris 46:163, 1970.
13. DAU, P.C. - Plasmapheresis in idiopathic inflammatory myophathy. Experience with 35 patients. Arch. Neurol. 38:544, 1981.
14. DAWKINS, R.L. - Experimental myositis associated with hipersensitivity to muscle. J. Path. Bact. 90:619, 1965.
15. DeVERE, R. & BRADLEY, W.G. - Polymyositis it's presentation, morbidity and mortality. Brain 98:637, 1975.
16. EATON, L.M. - The perspective of neurology in regard to polymyositis. A study of 41 cases. Neurology 4:245, 1954.
17. GARCIN, R. ; LAPRESLE, J.; GRUNER, J. & SCHERRER. J. - Les polymyosites. Rev. neurol. (Paris) 92:465, 1955.
18. HANISSIAN, A.S.; MASI, A.T. ; PITNER, S.E.: CAPE, C.C. & MEDSGER, T.A. - Polymyositis and dermatomyositis in children: an epidemiologic and clinical comparative analysis. J. Rheum. 9:390, 1982.
19. HAUDT, H.M. & HUTCHINS, G.M. - The heart and cardiac conductor system in polymyositis-dermatomyositis: a clinicopathologic study of 16 autopsied patients, Amer. J. Cardiol. 50:998, 1982.
20. HENRIKSSON, K.G. & SANDSTEDT - Polymyositis - treatment and prognosis: a study of 107 patients. Acta, neurol. scand. 65:280, 1982.
21. HUDGSON, P. & WALTON, J.N. - Polymyositis and other inflammatory myopathies. In P.J. Vinken & G.W. Bruyn (eds.): Handbook of Clinical Neurology. North Holland, Amsterdam, 1979, vol. 41, pg. 51.
22. LOGAN, R.G.; BANDERA, J.M. ; MIKKELSEN, W.M. & DUFF, I.F. - Polymyositis: a clinical study. Ann. int. Med. 65:996, 1966.
23. MEDSGERIT, A.; DAWSON, W.N. & MAST, A.T. - The epidemiology of polymyositis. Amer. J. Med. 48:715, 1970.
24. PAGES, M. & PAGES, A.M. - Apport de la biopsie musculaire au diagnostic des polymyositis: à propos de treize observations. Sem Hôp. Paris 59:610, 1983.
25. PEARSON, CM. - Polymyositis. Ann. Rev. Med. 17:63, 1966.
26. RIDDOCH, D. & MORGAN-HUGHES, J.A. - Prognosis in adult polymyositis. J. neurol. Sci. 26:71, 1975.
27. ROSE, A.L. & WALTON, J.N. - Polymyositis a survey of 89 cases with particular reference to treatment and prognosis. Brain 89:747, 1966.
28. SCHON, F.; THOMAS, P.K. & SENANAYAKE, L.F. - Remission from polymyositis after total body irradiation. Brit. med. J. 285:290, 1982.
29. SCHWARZ, H.A.; SLAVIN, G.; WARD, P. & ANSELL, B.M. - Muscle biopsy in polymyositis and dermatomyositis: a clinicopathological study. Ann. Rheum. Dis. 39:500, 1980.
30. WALLACE, D.J.; MTETZGER, A.L. & WHITE, K.K. - Combination immunosupressive treatment of steroid - resistant dermatomyositis - polymyositis. Arthr. and Rheum. 28:590, 1985.
31. WALTON, J. - The inflammatory myopathies. J. royal Soc. Med. 76:998, 1983.
32. WINKELMANN, R.K.; MULDER, D.W.; LAMBERT, E.H.; HOWARD, F.M. & DIESSNER, G.R. - Course of dermatomyositis-polymyositis: comparison of untreated and cortisone-treated patients. Mayo Clin. Proc. 43:545, 1968.
33. YOSHIOKA, M.; OKUNO, T. & MIKAWA, H. - Prognosis and treatment of polymyositis with particular reference to steroid resistent patients. Arch. Dis. Child. 60:236, 1985.

Datas de Publicação

Publicação nesta coleção
22 Jun 2011
Data do Fascículo
Jun 1987

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. ARAHATA, K. & ENGEL, A.G. - Monoclonal antibody analysis of mononuclear cells in myopathies: III. Immunoelectronic microscopy aspects of cell-mediated muscle fiber injury. Ann. Neurol. 19:112, 1986.

[2] 2. BANKER, B.G. & VICTOR, M. - Dermatomyositis (systemic angiopathy) Of childhood. Medicine (Baltimore) 45:261, 1966.

[3] 3. BARNES, B.E. - Dermatomyos.t.s and malignancy: a review of the literature. Ann. Med. 84:68, 1976.

[4] 4. BARWICK, D.D. & WALTON, J.N. - Polymyositis. Amer. J. Med. 35:646, 1963.

[5] 5. BEHAN, W.M.H. ; BARKAS, T. & BEHAN, P.D. - Detection of immune complexes in polymyositis. Acta neurol. scand. 65:320, 1982.

[6] 6. BENBASSAT, J.; GEFEL, D. ; LARHOLT, K. ; SUKENIK, S. ; MURGENSTERN, V. & ZLOTNICK, A. - Prognostic factors in polymyositis-dermatomyositis : a computer-assisted analysis of ninety-two cases. Arthr. and Rheum. 28:249, 1985.

[7] 7. BENNINGTON, J.L. & DAU, P.C. - Patients with polymyositis and dermatomyositis who undergo plasmapheresis therapy. Arch. Neurol. 38:553, 1981.

[8] 8. BOHAN, A. & PETERS, J.B. - Polymyositis and dermatomyositis. N. Engl. J. Med. 292:403, 1975.

[9] 9. BOHAN, A.; PETERS, J.B. ; BOWMAN, R.L. & PEARSON, CM. - A computer-assisted analysis of 153 patients with polymyositis and dermatomyositis. Medicine (Baltimore); 56:255, 1977.

[10] 10. BROWN, M. ; SWIFT, T.R. & SPIES, S.M. - Radioisotope scanning in inflammatory muscle disease. Neurology 26:517, 1976.

[11] 11. BUNCH, T.W. - Prednisone and azathioprine for polymyositis. Arthr. and Rheum. 24:45, 1981.

[12] 12. CABANEL, G. ; VOOG, R. ; MARCHAL, A. & COUDERC, P. - Polymyosite aique oedémateuse. Sem. Hôp. Paris 46:163, 1970.

[13] 13. DAU, P.C. - Plasmapheresis in idiopathic inflammatory myophathy. Experience with 35 patients. Arch. Neurol. 38:544, 1981.

[14] 14. DAWKINS, R.L. - Experimental myositis associated with hipersensitivity to muscle. J. Path. Bact. 90:619, 1965.

[15] 15. DeVERE, R. & BRADLEY, W.G. - Polymyositis it's presentation, morbidity and mortality. Brain 98:637, 1975.

[16] 16. EATON, L.M. - The perspective of neurology in regard to polymyositis. A study of 41 cases. Neurology 4:245, 1954.

[17] 17. GARCIN, R. ; LAPRESLE, J.; GRUNER, J. & SCHERRER. J. - Les polymyosites. Rev. neurol. (Paris) 92:465, 1955.

[18] 18. HANISSIAN, A.S.; MASI, A.T. ; PITNER, S.E.: CAPE, C.C. & MEDSGER, T.A. - Polymyositis and dermatomyositis in children: an epidemiologic and clinical comparative analysis. J. Rheum. 9:390, 1982.

[19] 19. HAUDT, H.M. & HUTCHINS, G.M. - The heart and cardiac conductor system in polymyositis-dermatomyositis: a clinicopathologic study of 16 autopsied patients, Amer. J. Cardiol. 50:998, 1982.

[20] 20. HENRIKSSON, K.G. & SANDSTEDT - Polymyositis - treatment and prognosis: a study of 107 patients. Acta, neurol. scand. 65:280, 1982.

[21] 21. HUDGSON, P. & WALTON, J.N. - Polymyositis and other inflammatory myopathies. In P.J. Vinken & G.W. Bruyn (eds.): Handbook of Clinical Neurology. North Holland, Amsterdam, 1979, vol. 41, pg. 51.

[22] 22. LOGAN, R.G.; BANDERA, J.M. ; MIKKELSEN, W.M. & DUFF, I.F. - Polymyositis: a clinical study. Ann. int. Med. 65:996, 1966.

[23] 23. MEDSGERIT, A.; DAWSON, W.N. & MAST, A.T. - The epidemiology of polymyositis. Amer. J. Med. 48:715, 1970.

[24] 24. PAGES, M. & PAGES, A.M. - Apport de la biopsie musculaire au diagnostic des polymyositis: à propos de treize observations. Sem Hôp. Paris 59:610, 1983.

[25] 25. PEARSON, CM. - Polymyositis. Ann. Rev. Med. 17:63, 1966.

[26] 26. RIDDOCH, D. & MORGAN-HUGHES, J.A. - Prognosis in adult polymyositis. J. neurol. Sci. 26:71, 1975.

[27] 27. ROSE, A.L. & WALTON, J.N. - Polymyositis a survey of 89 cases with particular reference to treatment and prognosis. Brain 89:747, 1966.

[28] 28. SCHON, F.; THOMAS, P.K. & SENANAYAKE, L.F. - Remission from polymyositis after total body irradiation. Brit. med. J. 285:290, 1982.

[29] 29. SCHWARZ, H.A.; SLAVIN, G.; WARD, P. & ANSELL, B.M. - Muscle biopsy in polymyositis and dermatomyositis: a clinicopathological study. Ann. Rheum. Dis. 39:500, 1980.

[30] 30. WALLACE, D.J.; MTETZGER, A.L. & WHITE, K.K. - Combination immunosupressive treatment of steroid - resistant dermatomyositis - polymyositis. Arthr. and Rheum. 28:590, 1985.

[31] 31. WALTON, J. - The inflammatory myopathies. J. royal Soc. Med. 76:998, 1983.

[32] 32. WINKELMANN, R.K.; MULDER, D.W.; LAMBERT, E.H.; HOWARD, F.M. & DIESSNER, G.R. - Course of dermatomyositis-polymyositis: comparison of untreated and cortisone-treated patients. Mayo Clin. Proc. 43:545, 1968.

[33] 33. YOSHIOKA, M.; OKUNO, T. & MIKAWA, H. - Prognosis and treatment of polymyositis with particular reference to steroid resistent patients. Arch. Dis. Child. 60:236, 1985.